Hi Everyone. I am glad I found this forum. I have been diagnosed with prostate cancer and have been lurking for a few weeks. You all have been been informative. I think this is a very valuable setting, particularly to a newbie like me.
My stats are in my signature below. I'm struggling with the question of what to do now. I have pretty much ruled out radiation because my urologist informed me that the recurrance rate, down the line, is higher than with surgery. Of course, he's a robotic surgeon who has performed about
open prostatectomies and about
300 robotic surgeries. I consulted with a radiation oncologist and he painted a beautiful picture of a full cure with practically no side effects. His story was too good to be true and contradicted what I have read elsewhere. My prostate size rules out everything except surgery and external beam radiation.
I have decided surgery is probably the best course of action for me, but I want to be sure I have the right surgeon. My prostate, at 96 cc, is really large and my urologist tells me this is a complicating factor in doing the surgery and in urinary and potency outcomes. Also, I had a right side laporscopic inguinal hernia repair in 2006 which is also a complicating factor. I really would like to interview 2 additional surgeons (besides my urologist who operates at St. Joseph Mercy Hospital in Ann Arbor, MI), one at the Henry Ford Vattikuti Institute in Detroit and one at the University of Michigan Health System. My problem is there is a huge lead time in scheduling an appointment. My biopsy was on Nov. 7. My urologist, at this point, could not perform the surgery until sometime in March. My appointment at Henry Ford is in late February which would translate into a surgery probably not until April atthe earliest. I imagine the lead times at U of M are similar.
My real question is, can I wait that long to carefully interview additional surgeons, or should I quickly schedule a March surgery with my existing urologist to lessen the chance of metastatic issues? My urologist says I do have considerable time since my cancer is so small and localized, however the Gleason 4 component worries me. While my urologist is very experienced and well-respected, one thing does cause me concern. He stated that his statistics on bilateral nerve-sparing is at 60%, yet his positive margins are in the 10% to 15% range. Shouldn't his bilateral nerve-sparing be in the same range as his positive margins (why cut out nerves if there is no positive margin)? Does anyone have any opinions about
this? Should I interview more surgeons or am I risking the cancer spreading by waiting too long? Thank you all so much!
Age: 59, 59 at DX
PSA: 1/20/00 7.9, 7/22/00 3.3, 10/25/01 4.9, 10/19/04 5.1, 9/26/07 5.98, 8/28/08 7.68, 9/23/08 7.36, 10/23/08 8.64, 12/18/08 6.39
Prostate size: 96cc
Biopsy: 11/7/08 Positive 2 of 15 cores, both in rt apex, composite tumor quantity 5% prostate involved, Gleason 7 (3+4), Gleason pattern 4 accounts for 15% of tumor
Post Edited (MichGuy) : 1/10/2009 11:55:48 AM (GMT-7)